Minimally abnormal pap testing and cervical histology in hiv-infected women

Christine Curry, Yael Hoffman Sage, Olivera Vragovic, Elizabeth A. Stier

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To assess the underlying histology of HIV-infected women with minimally abnormal Pap tests compared to HIV-uninfected women by evaluating their colposcopic and histologic outcomes. Methods: Retrospective analysis was performed to identify HIV-infected women who had at least one cervical Pap test from 2002 through 2008 at Boston Medical Center. We identified women who underwent colposcopy within 6 months of a minimally abnormal Pap test (atypical squamous cells of undetermined significance with positive high-risk human papillomavirus testing [ASCUS/HPV+] or low-grade squamous intraepithelial lesion (LSIL)). Our outcome was the proportion of HIV-infected women with histologic cervical intraepithelial neoplasia 2 or worse (CIN2+). We then compared these outcomes to those of a cohort of HIV-uninfected women from the same institution. Results: There were 655 HIV-infected women who had Pap testing in the study time frame, and 146 (22%) had a minimally abnormal Pap test (ASCUS/HPV+ or LSIL). Of the 90 HIV-infected women who had subsequent colposcopy within 6 months, colposcopy was negative for 20 (22%), CIN1 for 41 (46%), and CIN2+ for the remaining 29 (32%). During the same time period, there were 747 HIV-uninfected women who underwent colposcopy within 6 months of a minimally abnormal Pap test. Colposcopy was negative for 336 (45%), CIN1 for 254 (34%), and CIN2+ for 157 (21%). After adjusting for differences in age and race, the HIV-infected women were more likely to have CIN2+ after a minimally abnormal Pap test (p=0.002) (adjusted odds ratio [OR] 2.17, 95% confidence interval [CI] 1.33-3.62). There were no diagnosed cases of cervical cancer. Conclusions: HIV-infected women have higher rates of underlying CIN2+ for minimally abnormal Pap tests compared with HIV-uninfected women.

Original languageEnglish (US)
Pages (from-to)87-91
Number of pages5
JournalJournal of Women's Health
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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Histology
Papanicolaou Test
HIV
Colposcopy
Cervical Intraepithelial Neoplasia
Uterine Cervical Neoplasms
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Minimally abnormal pap testing and cervical histology in hiv-infected women. / Curry, Christine; Sage, Yael Hoffman; Vragovic, Olivera; Stier, Elizabeth A.

In: Journal of Women's Health, Vol. 21, No. 1, 01.01.2012, p. 87-91.

Research output: Contribution to journalArticle

Curry, Christine ; Sage, Yael Hoffman ; Vragovic, Olivera ; Stier, Elizabeth A. / Minimally abnormal pap testing and cervical histology in hiv-infected women. In: Journal of Women's Health. 2012 ; Vol. 21, No. 1. pp. 87-91.
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abstract = "Objective: To assess the underlying histology of HIV-infected women with minimally abnormal Pap tests compared to HIV-uninfected women by evaluating their colposcopic and histologic outcomes. Methods: Retrospective analysis was performed to identify HIV-infected women who had at least one cervical Pap test from 2002 through 2008 at Boston Medical Center. We identified women who underwent colposcopy within 6 months of a minimally abnormal Pap test (atypical squamous cells of undetermined significance with positive high-risk human papillomavirus testing [ASCUS/HPV+] or low-grade squamous intraepithelial lesion (LSIL)). Our outcome was the proportion of HIV-infected women with histologic cervical intraepithelial neoplasia 2 or worse (CIN2+). We then compared these outcomes to those of a cohort of HIV-uninfected women from the same institution. Results: There were 655 HIV-infected women who had Pap testing in the study time frame, and 146 (22{\%}) had a minimally abnormal Pap test (ASCUS/HPV+ or LSIL). Of the 90 HIV-infected women who had subsequent colposcopy within 6 months, colposcopy was negative for 20 (22{\%}), CIN1 for 41 (46{\%}), and CIN2+ for the remaining 29 (32{\%}). During the same time period, there were 747 HIV-uninfected women who underwent colposcopy within 6 months of a minimally abnormal Pap test. Colposcopy was negative for 336 (45{\%}), CIN1 for 254 (34{\%}), and CIN2+ for 157 (21{\%}). After adjusting for differences in age and race, the HIV-infected women were more likely to have CIN2+ after a minimally abnormal Pap test (p=0.002) (adjusted odds ratio [OR] 2.17, 95{\%} confidence interval [CI] 1.33-3.62). There were no diagnosed cases of cervical cancer. Conclusions: HIV-infected women have higher rates of underlying CIN2+ for minimally abnormal Pap tests compared with HIV-uninfected women.",
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